Monthly Archives: May 2010

Post navigation

I’ve been thinking a lot about statistics and studies lately. I can thank Rebecca Goldin and Polly Palumbo for this, since reading their work has taught me to look at numbers and research with a more critical eye.

Case in point: a good friend texted me early in the week about the latest study linking sunscreen use to cancer. There were many exclamation points and frowny-faces in the text, as well as a link to a foreboding article about the study. This one had scared her. Granted, she literally bathes her toddler in SPF 50, but what can you do? We live in sunny LA. It’s practically child abuse not to carry California Baby Sunscreen with you at all times. Anyway, before I even glanced at the article which had spooked her so, I knew what the real story would be. Correlation. Here’s two immediate theories:

1. People who wear high-level sunscreen might have a false sense of security about their time in the sun. Maybe they don’t reapply as often as they should.

2. Very possibly, these are same people who have a higher risk of skin cancer due to family history. Why else would you spend the money (and forgo that guilt-free “breakthrough tan” possible with the lower SPFs) on SPF 50 or higher?

I wasn’t completely correct in my assumptions; there was talk of the Vitamin A in the sunscreen speeding up UV exposure, and some concern that other chemicals used in these lotion could actually cause cancer (one report I heard from our local Fox affiliate suggested that the only people who might want to heed this warning is parents of kids under 2; their skin might be more susceptible to these chemicals). But many of the doctors interviewed in the media fallout from this study did refer to similar correlation theories. Like so many of these media-touted studies, it’s imperative for us to think critically about what we hear, and not jump to the same doomsday conclusions as our media brethren.

What does all of this have to do with formula feeding? A lot, I think. When I read breastfeeding/formula studies, I don’t go into it wanting to disprove the superiority of breastmilk; to the contrary, I think that anytime Mother Nature kicks technology’s ass, it’s pretty darn cool. But I do want to separate truth from overblown claims; to see the reality in the science, the human face behind the statistics.

Statistics are like sexy bad boys. They can be thrillingly dangerous, and look so promising – if you can just tweak them a bit to make them into a better version of themselves. They make an impression. But they mislead; they can be all gloss and no substance. Sometimes, there’s a wonderful heart under a rough exterior; not all bad boys are truly bad. You just need to go into the relationship with your eyes open, and realize that there might be more than they are showing you at first.

Like I said: it’s about reading the studies critically.

Which is why I was so thrilled to find Joel Best’s book, Damned Lies and Statistics: Untangling Numbers from the Media, Politicans, and Activists(University of California Press, 2001). It’s a few years old, but remains as topical as ever. Consider it required reading for all FFFs. I promise you, it’s not your father’s statistics book. It’s funny, acerbic, and easy enough for someone who dropped out of math junior year in high school (ahem, moi) to understand. Don’t believe me? You can read the introduction here. If you don’t love it, you can write me and tell me to shove it. Pinky swear.

The following essay, written by FFF Sarah, is one of the coolest FFF Friday submissions I’ve ever received. We can never know, at first glance, what was behind someone’s decision to formula feed…which is why it is so important to defend that choice, and respect that mothers can and domake the best decisions for their particular situation.

***

From the time I was a little girl, I dreamed of being a mommy. My family always called me “little mommy” and I took great pride in fussing over my younger siblings and cousins. I just always assumed I would have a big family…and that I would deliver them vaginally, breastfeed, buckle them into carseats, wipe away their tears, and rock them to sleep. These things were just the norm…I had no idea the rollercoaster ride I was in store for.

Very soon after getting married, I found out I was pregnant and subsequently miscarried. We tried on our own for a few months, and then worked with our OBGYN for a few months, before we were referred to an reproductive endocrinologist (RE). We were diagnosed with male factor infertility (MFI) and unspecified ovarian dysfunction (which, in our case, meant the doctor had no idea what was wrong — one month tests would be fine, the next, not fine — one month I would ovulate, the next, not so much). We went through countless treatments and ended up getting pregnant again, and miscarried again. Somewhere along the way, we decided to go ahead and pursue adoption. For many personal reasons, we have always felt like we would adopt, we just also expected to have biological children. We embraced adoption with the same fervency we had fertility treatments and we researched, researched, researched.

When we were matched with our baby girl, immediately it dawned on me that I needed to spend some time researching the parenting side of adoption. I had already grieved the fact that my body would not be growing her and I wouldn’t be physically giving birth, so now I had some decisions to make in regards to how we would nourish her. I had certainly heard of adoptive breastfeeding and knew it was possible, so after a great deal of Google research, I made appointments with a lactation consultant, my OBGYN, my RE, and a therapist, and began to speak with other adoptive moms about breastfeeding. I had two subsequent appointments with two additional lactation consultants, and spent more time than I’m willing to admit lurking on a popular breastfeeding board. And what it all boiled down to was that I needed to take drugs to induce lactation, along with herbs, and rent a hospital grade pump and I needed to start months before my daughter was born. There were no promises that I would produce anything, much less enough to feed my daughter.

I spent several agonizing months discussing the pros and cons with my therapist and the pediatrician we had selected for our daughter, and weighing all of the opinions and my own feelings with my husband. In the end, I decided that what would be best for my daughter, would be a happy mommy. And the risk of my body failing me in my attempts to breastfeed, on top of the grief and guilt I had already experienced going through fertility treatments and miscarriage over the past two years, was enough to make me realize that failure would likely push me over the edge. It was more important to me to be happy and mentally healthy so I could focus on bonding with my beautiful baby, than it was to breastfeed her. I was very lucky that the ONLY negative experience I had in my researching efforts (outside of what I read on the internet) was from the lactation consultants I had visited with. Unfortunately, one of them was downright ugly about the fact that I was adopting, and the other two had an obvious agenda based on their over-exaggerations in highlighting the pros of breastfeeding (e.g. since my baby was adopted, she would not bond with me if I did not breastfeed her — both of them touched on this and I was highly offended on behalf of adoptive parents everywhere that they would even suggest this). My OBGYN and pediatrician both reassured me that while breastfeeding is completely natural and best for baby, the results of studies were not convincing to them and they felt that formula was a perfectly healthy alternative for our baby and it would not interfere with bonding in the least.

The only negative experience I have had formula feeding, are the total strangers who shoot me dirty looks when I pull a bottle out of the diaper bag to feed her in public. And even worse are those who actually have the gall to say something to me. I’ve had a woman tell me that I am poisoning my daughter, and another that formula is child abuse. For those of you who are “lactivists”…your voice would be much louder if you would whisper your message to other mothers with love, because shouting your message with hate makes mothers feel attacked and defensive. I am still pro-breastfeeding, although saddened by the way the message is delivered based on my own experiences, and if I ever do have a biological child, I would love to attempt to breastfeed. If however, I am unable to breastfeed for whatever reason, or if we adopt again, I will remind myself that at almost 7 months old, we have a perfectly happy (well-bonded) baby, who is meeting and exceeding milestones, and is the picture of health. I am proud of my decision and proud of myself for making it.

***

Feel like unloading some old baggage? Tell your story for an upcoming FFF Friday…you might find it surprisingly cathartic. At the very least, you’ll have my eternal gratitude. Send submissions to formulafeeders@gmail.com.

Infant formula is comparable to skin lightening creams….or so says South African Minister of Health Aaron Motsaledi. The latter is banned in his country; if he had his druthers, so would be the former. In fact, News24 reports that he planned to bring up the idea of banning formula worldwide at the World Health Assembly; I’m not sure if he followed through with this proclamation, but if did, I wouldn’t be surprised if he was met with a rousing standing ovation.

To be fair, I’m going to assume that Motsaledi was somewhat misquoted. I haven’t been able to find transcripts from the actual conference where he made these statements, and the news reports are a bit vague as to whether he was talking about banning infant formula altogether, or just formula advertising. Obviously, if he was just asking for a moratorium on formula ads, this wouldn’t be much different from WHO code, and not really worth blogging about.

But regardless of the semantics, I’m afraid that Dr. Motsaledi is trying to put a band-aid on a gaping wound. His animosity towards formula stems from his belief that it is contributing substantially to his country’s infant mortality rate, which has unfortunately been going up rather than down (7% of children die before their fifth birthday, compared to only 5% twenty years prior). The statistics I found suggest that the two top causes of death for South African infants are cardiovascular/respiratory problems and gastrointestinal infections, both of which could potentially be mitigated by breastfeeding (especially if the water supply is compromised in some of these rural areas, diseases of the gut could be a very real threat for formula fed infants).

Still, South Africa is dealing with a major HIV/AIDS problem, and while some do believe that HIV positive mothers (at least those in substandard living conditions) are better off breastfeeding, others warn that the disease can easily be passed through breastmilk. So, there’s that problem. Plus, breastfed babies are still at risk of contagious diseases (even if there is immunity passed through breastmilk, it’s not an infallible system, by any means), birth defects, and poor post-weaning nutrition. I certainly agree that it is in the best interest of South African babies in rural areas to breastfeed, but I think it’s unfair to assume that this will be a cure-all, ignoring the myriad of other health and social problems facing this country.

And yet, that isn’t really my beef with Motsaledi. That’s just the ketchup. The patty, bun and cheese are his blanket statements that the dire need for breastfeeding in certain areas of his country is identical to the need for breastfeeding in the rest of the world. It is a very different animal when you look at infant mortality in the United States or Canada, for example. I know in our politically over-correct society, no one likes to talk about cultural, social, racial or economic differences, but they exist. Pretending they don’t won’t make them disappear. If you live somewhere with clean water and good access to health care, breastfeeding becomes less of a lifesaving mechanism and more of a life-enhancing one (for those who can make it work, of which there are luckily many). I think it’s no more fair to assume I can viscerally understand the situation of someone in rural Africa than it would be for Motsaledi to assume he can understand mine. To compare something that can actually be lifesaving in it’s own right to a cosmetic treatment tied up with a whole mess of negative-ethnic-idenity and racist baggage… I think it’s – for lack of a better or non-offensive word - goofy.

One more thing (umm…maybe this is the fries? Can’t forget the fries). Motsaledi, who worked as a physician in rural areas of South Africa before taking his post as Minister of Health, claims that “in those areas, women sought the slightest excuse to not breastfeed.” Interesting choice of words. I think he might doing something similar – seeking the slightest excuse to oversimplify the complex nature of infant health in his country.

This week’s anonymous FFF Friday contributor dealt with a heck of a lot more dire issues than how and what to feed her child. These types of stories are important to hear, to remind us that while deciding to breastfeed/formula feed is an important decision to make, sometimes life gets in the way of our best laid plans. And when that happens, it’s good to know that we have options, resources, and support, no matter what we are dealing with.

***

I didn’t commit to a lot of things before our son was born, for the simple fact that I believe some events are way out of my control. I preferred to read and research and then go into things with an open mind. This meant that I was pretty ambivalent about breastfeeding in the grand scheme of things. If it worked out, great. If it didn’t, that was great, too.

My son was born early at 37 weeks. Not early enough to be a real preemie, but early enough to have pinholes in his heart. He was having great difficulty eating in his first 24 hours, which the nurses attributed to the concept that some early babies just haven’t developed their suck yet. Our interest was in getting him fed, and since my body hadn’t really caught up to the birth yet, formula was the nourishment of choice. As the eating issues continued, further investigation showed a blockage in his intestines (later determined to be a meconium plug). Within 45 minutes of that x-ray, our son was transferred by ambulance to a NICU 30 miles away.

The plug was flushed several hours later and we were sent home, while he stayed for observation. As a nurse was feeding him, his heart rate dropped dramatically and he turned blue. Testing revealed an Atrial Septal Defect, a literal hole (or several holes, in this case) in the wall between the chambers of the heart.There was a lot of talk of surgeries, procedures and testing. There were wires and alarms. I watched my husband fall to pieces (we both were, but someone had to be the rock).

We were terrified. But I needed to be clear and focused for what might come. I couldn’t justify struggling with any added challenges in those first few weeks in the NICU, and all the months when he was home and on constant surveillance from a heart monitor. Our son needed me to be strong enough for all of us.

We were lucky. The pinholes closed on their own, and one year later, our son was cleared by his cardiologist. He will be two years old in a few weeks. He is 37″ tall, 34 lbs and has been off the charts since his first well-visit. He speaks in 3, 4 and 5 word sentences with excellent articulation. His first actual illness (a small infection) was last month. Other than his cardiologist, well visits and one appointment for a yeast rash, we have not had to visit the doctor. We are so grateful for our healthy, smart, amazing little boy and I have never once regretted the decisions we made in his feeding.

***

Guys, I’m running out of FFF Friday submissions. Don’t make me actually have to write a flippin’ post on a Friday. Not to mention that you guys are probably sick of my ranting. I know there’s more of you out there… Adoptive moms? Dads? Bueller? Email me at formulafeeders@gmail.com.

I’m helping out with a small documentary being made about formula feeding (portraying us positively for once) and we’re looking for people in California and Pennsylvania (random, I know, but that’s where the filmmakers are located) who would be willing to talk on camera about their experiences.

If you live in one of these areas and would be interested in hearing more about this opportunity, please let me know. I realize it’s scary to be on film talking about something so controversial, but with the upcoming release of (dramatic sigh) Formula Fed America, I think it’s really important for us to show the world that there are legitimate reasons women may not be breastfeeding, and that formula feeders are intelligent, compassionate, and articulate – which I know to be true, from the comments on this blog.

Shoot me an email at formulafeeders@gmail.com and I will let you know more about this (hopefully) worthwhile project.